AI Article Synopsis

  • The study investigated the impact of lanreotide on high-output stomas (HOS), which can cause serious complications like dehydration and renal failure in about 3-16% of patients.
  • The research involved a randomized trial comparing patients receiving lanreotide combined with antidiarrhoeal treatments against those receiving antidiarrhoeal treatments only, focusing on ileostomy output after 72 days.
  • Results showed no significant differences in stoma output, renal function, or hospital stay lengths, leading to an early termination of the trial due to low patient enrollment and ongoing uncertainty about the effectiveness and cost of somatostatin analogues in treating HOS.*

Article Abstract

Background: The incidence of high-output stoma (HOS) was reported to be approximately 3 to 16% in the literature, and HOS can cause dehydration. This complication is often severe enough to warrant hospital readmission and may result in renal failure. The aim of this study was to show a decrease of 50% in ileostomy output in the experimental arm using lanreotide treatment.

Methods: Patients with an ileostomy output ≥ 1.5 l/24 hours were included in this prospective, open, multicentre randomized trial. Patients were randomly allocated between treatment arms with either lanreotide (LAN) and antidiarrhoeal treatments (TAD) (LAN-TAD group) or antidiarrhoeal treatments only (TADS group). The primary outcome was ileostomy output after 72 days. The secondary endpoints were ileostomy output during the first 6 days, blood urea and creatinine values, hospital length of stay and serious adverse events.

Results: In the per-protocol analysis, there were nine patients in the control group (TADS) and six patients in the experimental group (TAD-LAN group). The stoma outputs at Day 3 (D3) in the experimental and control groups were 1,900 ± 855.7 mL and 1,728.6 ± 845.5 mL, respectively ( = 0.2). No differences were found concerning stoma output at D6, renal function, or hospital length of stay between the two groups.

Conclusion: The trial was prematurely stopped due to the low number of patients included. The question of the usefulness of somatostatin analogues in HOS persists, especially as the cost of this treatment is high, and there is a lack of evidence of its effectiveness.

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Source
http://dx.doi.org/10.1080/08941939.2020.1800871DOI Listing

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